The Lead Untangles: The push to regulate therapy
A new petition says it’s time to regulate the profession– but therapists and clients disagree
At the moment in the UK, anyone can call themselves a counsellor or psychotherapist, but a new petition hopes to change that.
A petition has been launched calling for both professions to become protected titles, regulated by the Health and Care Professions Council (HCPC), Just over 6,000 signatories have supported the petition at the time of writing.
The HCPC protects 15 professions in the UK, including art therapists and psychologists. But counsellors and therapists are not. Many professionals in the therapy industry want to see this change — but some therapists and clients disagree.
Context
There are two issues at stake at the moment.
The first is that anyone can call themselves a counsellor or therapist, because it’s not a protected title. Secondly, there is no way to stop counsellors and therapists from working if they are not fit to practice, because they are not registered with a statutory body.
According to the petition: “Unregulated ‘influencers’, ‘life coaches’ and in some cases negligent practitioners can cause iatrogenic harm and family breakdown without, in our view, proper accountability. We believe some struck-off practitioners can rebrand without oversight. Statutory regulation could end the ‘Wild West,’ restore public confidence, and protect the integrity of the profession by ensuring all practitioners meet national safety and ethical standards.”
One of the accredited bodies, the British Association for Counselling and Psychotherapy (BACP), reports on the complaints its receives. While numbers are still relatively low (involving less than 1 per cent of its membership), complaints have risen year on year since 2020, jumping 26 per cent between 2022 and 2023.
Most therapists and counsellors join an ‘accredited register’ to reassure clients that they adhere to a professional code of conduct. If an accredited therapist makes a mistake, the client has some reassurance that they can raise a concern to the accrediting body. The BACP runs a confidential phone and email service where clients of any therapist can advise on concerns about a practitioner.
But for many practitioners and clients, this isn’t enough. There is currently no statutory threshold for what qualifies a person to practice as a therapist or counsellor in the UK. There is also no way to prohibit a person from practising as a therapist, even if they are denied or removed from one of the accredited registers.
For example Michael Lousada was prosecuted through the civil courts in 2024 after he sexually assaulted a client during a therapy session. But even if no register will accredit him, nothing stops him resuming his practice as a therapist — bar his reputation — because the title is not protected by law.
For some, regulating the industry has become an increasingly important political goal. MPs Chris Webb, Rachel Maskell and Nadia Whittome all recommended that the industry be regulated to protect patients and clients in 2024.
How would legislation work?
When someone registers with the HCPC, anyone can look them up on its public register. It works similarly to the General Medical Council (GMC)’s register of doctors and the Nurses and Midwives’ Council (NMC)’s register of clinicians: anyone can check the status of someone claiming to be a qualified clinician.
The HCPC then protects the public by fielding concerns about a clinician’s ‘fitness to practice’ and in some cases, removing them from the register.
But the industry is already experiencing upheaval over something called the Scope of Practice and Education (SCoPEd). Six bodies, including the BACP, along with the National Counselling and Psychotherapy Society (NCPS), and UK Council for Psychotherapy (UKCP), are trying to create a shared framework to categorise therapists according to training and experience. They say this would create more of a framework around which therapists have the competency to do work, but the work has been heavily debated and the union (the Psychotherapy and Counselling Union – the only one unique to the profession) opposes it.
Who is in favour?
One of the big membership bodies is tentatively supportive.
Ellen Dunn, the UK Council for Psychotherapy’s policy and research manager, said: “UKCP has spent the past year engaging extensively with practitioners, sector stakeholders and experts by experience to develop clear principles for what statutory regulation must achieve.
“Membership of an accredited register is not compulsory, and that limits what any voluntary body can do to protect the public.”
Who is against it?
Two other accredited bodies say that the Professional Standards Authority (PSA) have been doing great work to strengthen the Accredited Registers programme this year.
Meg Moss, head of public affairs and advocacy at the National Counselling and Psychotherapy Society, said: “Regulation that simply seeks to protect titles isn’t going to protect the public, and even in statutorily regulated professions harm does still occur; but better public awareness of how to choose a qualified, accountable therapist on an Accredited Register will mitigate the issues around unqualified therapists.
“Despite the fact that it’s voluntary, joining an accredited register has become the de facto form of regulation in that the requirement to belong to one is standard for most employers.”
Meanwhile Dr Lisa Morrison, chief regulation and standards officer at the British Association for Counselling and Psychotherapy, said that regulation might just end up confusing would-be clients even more
Dr Morrison said: “We do not believe that the statutory regulation of protected titles is the silver bullet to public protection that it is often regarded as. The main risk is that if not developed appropriately, statutory regulation can add to public confusion and provide too many loopholes to enhance public protection.”
The Psychotherapy and Counselling Union is critical of the petition – and warns that if therapists are regulated then their employers should be too.
Liz Martin, general secretary of the union, said the petition’s scope was too small: “The issue of client safety has to be central to any discussion of possible further regulation – however, this cannot be all of the consideration. Regulation of therapy training, or procurers of therapy such as employee-assisted programmes, platforms and insurers, must also be included, as the burden of further regulation cannot fall exclusively on the psychotherapist and counsellor.”
Legislating therapy could make the profession safer but it could also make it more costly for practitioners (and clients, as a result). At the moment joining the HCPC costs around £123 a year with a one-off fee of £86. At the moment, therapists don’t have to pay any statutory fees to work, although many pay to join accredited bodies.
What happens next?
If the petition hits 10,000 by 3 August MPs are obliged to respond. But at the moment, it’s a long way off the number of signatories needed for a parliamentary debate.
If therapists became a regulated profession, they would likely have to register with a body (such as the HCPC). Without registering, they wouldn’t legally be allowed to practice – and it would be easy for a member of the public to look them up on the register to check they were fit to practice.
The drawbacks might be that not every therapist would be able to register – for example, those with less experience or training – which could have unintended consequences such as two-tier therapy, higher costs for clients, or narrowing the definition of who can call themselves a therapist.
But for some clients – and practitioners – narrowing the definition is the point. ■
About the author: Ellie Broughton has over 12 years’ experience writing about mental health and wellbeing for titles including The Guardian, the i paper, the Huffington Post, Lifehacker, patient.info, Stylist, The Independent, Refinery29 UK and Vice UK.
She specialises in topics including emerging modalities, depression in chronic conditions, therapy efficacy, bias and psychoanalytic ideas.
About The Lead Untangles: In an era where misinformation is actively and deliberately used by elected politicians and where advocates and opposers of beliefs state their point of view as fact, sometimes the most useful tool reporters have is to help readers make sense of the world. If there is something you’d like us to untangle, email ella@thelead.uk.
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